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Identify the work covered by this request:
I�NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR
GENERAL FEES �
SERVICES / POWER SUPPLIES
0 to 400 Ampere �$25 f/
REQUEST FOR ELECTRICAL INSPECTION
Minnesota Board of Electricity �
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
(651) 642-0800 TTY/MRS 1-800-627-3529
www.electricity.state.mn.us
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$ to 200 Am ere �$5 .�Q. �L
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Above 200 Ampere � $1
RM, COMMUNICATION, REMOTE CONTROL, SIG
�UITS, CIRCUITS OF LESS THAN 50 VOLTS
Each System Device or Apparatus �$.50
ADDITIONS TO THE GENERAL FEES
.TIFAMILY DWELLINGS (PER UNIn
3 to 12 Units �$50 Per Unit
Each Additional Unit � $25
OTHER ADDITIONAL FEES
LighSng Retrofit � $.25 per Fixture
Center Pivot Irtigatlon Boom � $40
Manufactured Home Park Lots � �
Traffic Signal Standard �
Suo�lemental Fee � $20
� Transformer / Power Supply for Signs / Outline Lighting �$5
ONE & TWO FAMILY DWELLINGS, EACH UNIT
Includes the Service andlor Power Suppty up to 500 Amperes, All
Circuits and Two Inspection Trips Each Dweiling Unit �$8(
Additional Inspection Trips � $20
Investiqative Fee
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total fee is
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IF NOT COMPLETED WITHIN 18 MONTHS
FOR OFFICE USE ONLY
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Reques[ Date: ;�r- Rough-in Inspection Required? ❑ Yes No Inspection Other Than Roughdrc ❑ Ready Now Will Call
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I certify that I am �e ❑ LICENSED CONTRACTOR ❑ COMPANY �OWNER and hereby request inspection of the electrical work at